Appealing Your Long-Term Disability Denial

When you have been rendered unable to work due to a medical condition that has led to a disability, the last thing you want to have is more problems to deal with. Most people think that because they have an insurance policy that covers long-term disability all they will have to do is apply for their long-term disability benefits and focus on getting better and back to work. The reality is that often legitimate long-term disability claims are denied by insurance companies.

While different long-term disability policies can vary in their terms, usually if you have been denied long-term disability benefits you have the option to appeal the decision through your insurance company’s internal appeal process.

How To Make The Most Of Your Appeal

No two long-term disability denials are ever the same, however, there are some steps you can take in appealing the denial of your long-term disability benefits that can never hurt:

  • Contact Your Insurance Company: The first thing you should do if you plan on appealing the denial of your long-term disability benefits is to contact your insurance company and make sure you have a firm understanding of the appeal process, how to submit relevant documents, and the timelines you have to act within.
  • Make Sure You Understand The Basis For Denial: Carefully review the denial letter you received from your insurance company to understand the reasons for the denial. This is important and will help guide you in addressing the specific issues in your appeal.
  • Read Your Insurance Policy: After you have read over the denial letter, review your long-term disability insurance policy to understand your entitlements under the policy and the specific criteria under your policy for receiving long-term disability benefits.
  • Gather Supporting Documentation: Collect all the documents you need to prove your ongoing disability. This can include medical records, test results, letters from treating physicians, and other relevant documentation that supports your claim for long-term disability benefits. Insurance policies often require the insured to provide the documents they base their decision on so make sure you give them everything they need.
  • Get Your Doctor On-Side: Once you have reviewed the denial letter and your insurance policy and have a good understanding of why you were denied long-term disability benefits, go to your doctor and discuss the basis for the denial with them. If you have your doctor on your side, it can make challenging a denial of long-term disability benefits much easier in the long run.
  • Submit Your Appeal Letter: Write a detailed appeal letter that addresses each reason for the denial of your long-term disability benefits, points out why you disagree with the insurance company’s decision to deny your claim and includes any new information or documentation that supports your position. Be as clear and concise as you can in your appeal letter.
  • Wait For The Decision And Watch The Clock: Once you’ve submitted your appeal letter, you have to wait for the decision of the insurance company. This can take a long time to arrive. In the meantime, the timeframe in which you have a right to start a lawsuit to enforce your rights to your long-term disability benefits is getting smaller. You have a limited amount of time in which you have to bring a claim in the Court system to enforce your rights to long-term disability benefits and once that time passes you will be statute barred from filing a lawsuit, so it is very important to seek legal advice before that time runs out.

Remember that the appeals process for long-term disability benefits can vary depending on your specific insurance policy and the insurance company. It’s important to act promptly and thoroughly in appealing a denial to increase your chances of a successful outcome.

The lawyers at Taylor & Blair LLP have created free e-books with tips on how to deal with your insurance company and advice on how to handle a denied long-term disability claim, which may help you in your appeal process.

Just Because You Appeal, Doesn’t Mean It Will Work

Unfortunately, just because you’ve made an appeal, it doesn’t mean you will get the insurance company to change their mind. The reality is that you’re asking the same organization that has already decided to deny your long-term disability benefits the same thing, perhaps only this time with more information. However, often insurance companies have policyholders sign documents allowing them to obtain the policyholder’s medical records, so the insurance company is likely already aware of any arguments you may make against their denial of benefits.

As noted above, there are specific timelines in which you have to start a lawsuit if you want to enforce your right to long-term disability benefits. The specific timelines can be insurance policy specific, so it is important to have an experienced insurance denial lawyer review your denial letter and insurance policy as soon as possible to ensure you understand your rights and the timelines that apply to you.

Contact one of our experienced insurance denial lawyers today for a free consultation for your long-term disability denial claim.